Accreditation Improved Response to H1N1

August 4, 2010

Last summer the North Carolina Institute for Public Health (NCPIH) did a “quick-strike” study to examine the impact of public health accreditation. This H1N1 research is part of the North Carolina Preparedness and Emergency Response Research Center and is funded by the Centers for Disease Control and Prevention. NCPIH presented their findings at this year’s NACCHO Annual conference in Memphis this past June, as part of a session on academic-based public health research.

During the summer of 2009, NCIPH collected information from nine public health agencies (five were accredited, and four were not). “There was wide variation in the scope and timing of local agency response to H1N1,” said Mary Davis, DrPH, MSPH, director of evaluation services with NCIPH. “The accredited agencies performed a broader scope of response activities, and implemented incident command and investigation activities more rapidly.”

The findings were used to encourage specific improvements in preparedness at the local health department (LHD) level. All nine agencies that participated in the study received After Action Reports. A research brief highlighted common areas of high performance and that needed more improvement. The document was disseminated to LHDs in the state and to the state Division of Public Health.

Finally, NCIPH are implementing the findings in future preparedness research, such as a larger preparedness survey that is now in the field. “Our ultimate goal is to inform preparedness measures in accreditation standards,” said Davis.

These findings demonstrate in part that the requirements of accreditation can drive a more systematic or effective approach to emergency response. Within the North Carolina Local Health Department Accreditation program, there are 18 specific standards related to preparedness and participating LHDs must present verifying documentation. “For example, personnel records must document that all personnel have received appropriate training, such as Incident Command System Training,” said Davis.

The North Carolina LHD Accreditation program is aiming to have all 85 LHDs in the state accredited—and functioning according to a standard that is consistent across county borders. So far, 50 agencies have obtained accreditation. A recent NCIPH survey showed that two-thirds of these are now conducting quality improvement activities. “We believe that accreditation provides agencies with a platform of capacity from which the agencies can then work towards improved results,” said Davis.